ArticleInternational journal for equity in health2017
Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa.
Article in International journal for equity in health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- "We are everything to everyone": a systematic review of factors influencing the accountability relationships of Aboriginal and Torres Strait Islander health workers (AHWs) in the Australian health system.International journal for equity in health · 2018Pooled it
- Assessment of community health workforce governance in federal Nepal.Health policy and planning · 2026Article
- Implementing active surveillance for tuberculosis: A quality improvement project.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
- Decentralized Management of Home Care Services for Seniors: Protocol for a Participatory Action Research.JMIR research protocols · 2025Article
- Contribution of health system governance in delivering primary health care services for universal health coverage: A scoping review.PloS one · 2025Article
- Home visits for preterm/low birthweight infants in South Africa: Qualitative evidence synthesis.African journal of primary health care & family medicine · 2024Article
- Article
- Future proofing health in response to climate change and rapid urbanisation in Africa.BMJ (Clinical research ed.) · 2024Article
- Article
- Human resource time commitments and associated costs of Community Caregiver outreach team operations in South Africa.PloS one · 2023Article
- Article
- Indicator-activities to apply primary health care principles in national or large-scale community health worker programs in low-and middle-income countries: a Delphi exercise.BMC public health · 2022Article
- Conceptual framework for systemic capacity strengthening for health policy and systems research.BMJ global health · 2022Review
- Strategies to adapt and implement health system guidelines and recommendations: a scoping review.Health research policy and systems · 2022Article
- Factors Associated With Workplace and Interpersonal Trust in the Supervisory System of a Community Health Worker Programme in a Rural South African District.International journal of health policy and management · 2022Article
- Community health workers at the dawn of a new era: 3. Programme governance.Health research policy and systems · 2021Review
- Community health worker models in South Africa: a qualitative study on policy implementation of the 2018/19 revised framework.Health policy and planning · 2021Article
- Governance of community health worker programs in a decentralized health system: a qualitative study in the Philippines.BMC health services research · 2021Article
- Strengthening the community health program in Liberia: Lessons learned from a health system approach to inform program design and better prepare for future shocks.Journal of global health · 2021Review
- 'We need other men to stand up and start the journey' engaging men as HIV community health workers - a gender transformative approach?Culture, health & sexuality · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNational community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy.
methodsA cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated.
resultsFour key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies.
conclusionsThis analysis, from real-life systems, adds to understanding of the processes involved in developing CHW programmes at scale, and specifically the negotiated and multilevel nature of leadership and governance in such programmes, spanning analytic, managerial, technical and political roles.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.